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HIV DNA and Neurocognitive Impairment in Older
and Younger Subjects on Suppressive ART
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Reported by Jules Levin
CROI 2025 Feb 23-26, Seattle, WA
Michelli Faria de Oliveira1, Ben Murrel1, Josue Perez-Santiago1, Milenka Vargas1, Ronald J Ellis2, Scott Letendre2, Igor Grant2, Davey M.
Smith3, Steven Paul Woods4, Sara Gianella1.
1University of California San Diego, La Jolla, California, USA, 2HIV Neurobehavioral Research Center, San Diego, California, USA, 3
Veterans Affairs San Diego Healthcare System, San Diego, California, USA and 4University of Houston, Texas, USA.
from Jules: this very interesting study compared older >50 to younger <40 in age HIV+ on suppressive ART <50 c/ml, and found of note that older people had higher inflammation & activation markers, of note CD163, associated with heart disease in HIV, was higher in older people underscoring the concern about increased risk for sub-clinical heart disease & non calcified coronary plaque that could rupture [http://www.natap.org/2013/HIV/031813_01.htm] in HIV which is of greater risk as people age, so although this study only looked at neurocognitive impairment, the same may apply to other comorbidities.
Program abstract Conclusions: Prior studies have linked the HIV DNA reservoir size to NCI and our findings identify that this association is strongest in HIV+ adults older than 50, along with IL-8, which we have previously linked to evidence of inflammation on brain magnetic resonance spectroscopy. These findings add to emerging evidence that the correlates of NCI differ in older and younger HIV+ adults, which supports tailoring therapy based on age. In addition, our findings suggest that interventions aiming to reduce the HIV DNA reservoir may impact the central nervous system.
RESULTS
· After adjusting for EDI (estimated duration of infection),
older individuals have higher levels of monocyte activation
and trafficking in blood (sCD163) and CSF (sCD163 and
MCP-1[activation marker]) compared to their younger counterparts.
See table.
· Higher levels of HIV DNA in blood CD4+ T cells were associated with
impairment (p=0.003) in older individuals (but not in younger). Figure 1A.
· Lower levels of MCP-1 in CSF were associated with impairment (p=0.04)
in younger individuals (but not in older) Figure 1B.
Reported by Jules Levin
CROI 2025 Feb 23-26, Seattle, WA
Michelli Faria de Oliveira1, Ben Murrel1, Josue Perez-Santiago1, Milenka Vargas1, Ronald J Ellis2, Scott Letendre2, Igor Grant2, Davey M.
Smith3, Steven Paul Woods4, Sara Gianella1.
1University of California San Diego, La Jolla, California, USA, 2HIV Neurobehavioral Research Center, San Diego, California, USA, 3
Veterans Affairs San Diego Healthcare System, San Diego, California, USA and 4University of Houston, Texas, USA.
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